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Table of Contents

Chapter IInversion TherapyHistory of inversion...................................................................3Traction and stretching...............................................................4The spine....................................................................................5Waist...........................................................................................6Organs........................................................................................6Flexibility...................................................................................6Blood flow..................................................................................7Medical Studies on Inversion Therapy.......................................7Health risks..............................................................................10Question...................................................................................11Exercises..................................................................................13

Chapter IITotal Body TrainingMax Gym Suspension Training...............................................19Exercises with MxGym Suspension Straps.............................21

References................................................................................29

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I INVERSION THERAPY HISTORY of INVERSION THERAPY.

This same question was asked nearly 2,500 years ago when, in 400 BC, Hippocrates used a complicated system of ladders and pulleys in order to remove weight from his patients’ spine in an attempt to reduce the effects of gravity. In the 1960s Dr. Robert Martin, a California-based chiropractor, osteopath and medical doctor, developed the “Gravity Guidance System.” His ideas, and use of inversion therapy, stemmed from 15 years of research on common activities such as standing, sitting and lying down, as well as more uncommon actions such as extended, brachiated and inverted postures. He took inversion therapy into the mainstream and challenged physicians and therapists to look at these uncommon postures as ways to counter the adverse effects of gravity. By 1980, inversion had begun gaining popularity as a therapy.

As inversion grew in popularity, Drs. Klatz and Goldman in 1983 published a study that all but eliminated inversion as a way to combat the negative effects of gravity. Their study concluded that there was “concern” with the use of full static inversion in individuals with a history of hypertension, cardiovascular disease and stroke. They recommended that general caution be observed among the elderly, who are at an increased risk for a cardiovascular accident. The media misinterpreted these findings, stating that inversion causes strokes, which all but destroyed inversion’s chances for existing as a therapy. In 1985 Dr. Goldman published a second study to help clarify what had been previously stated. Dr. Goldman’s second study led to the conclusion that the risk of stroke in previous studies appeared to be greatly exaggerated and that there have been no reports of stroke, cardiovascular

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accident (CVA) or serious injury with inversion. Furthermore, Goldman stated that there is more risk of CVA in standing posture and while weightlifting.

With the “scare” lifted, an increasing number of health-care providers began to use inversion as a form of treatment for a multitude of spinal health issues.

Traction and stretchingWhen the body's weight is suspended from the lower body – rather than borne on the hands as in handstands or headstands or hanging from a bar with arms at sides, which are also forms of inversion – the pull of gravity may decompress the joints of the body below the anchor. Hanging by the feet, as with gravity boots or inversion tables, causes each joint in the body to be loaded in an equal and opposite manner to standing in an identical position of joint alignment. Inversion therapy of this sort is often commercially advertised as a relief for back pain, but it is not widely regarded as a serious treatment.

Proponents claim that inversion therapy is particularly beneficial for the spine in that it relieves pressure on the discs and nerve roots; this in turn allows discs to recover lost moisture and to return to their original shape, decreasing the pressure they can exert on nerves. Skeptics note that pressure is also relieved when lying down in bed. Proponents counter that while gravity-related pressure is removed, the pressure of tight muscles is not, and that traction is needed to allow the possible space between spinal discs to be realized.

Holding the bones of the spine and legs together, the ligaments crossing the joints under traction are subjected to pulling forces, assisted by passive muscle tension, the skin, and the

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fascia. Proponents claim gradual introduction and increases of the intensity and duration of traction can cause stimulation for the strength of ligaments to increase.

The spineDiscs separate vertebrae, allow movement and provide shock absorption. Dangerous exercises or constant pounding from running can cause the discs to be compressed. The centre of the disc contains a jelly type liquid which can protrude out and put pressure on the nerves. Inverted, your body weight applies mild traction to the spine which becomes slightly longer. This increases the space between the vertebrae and reduces the pressure on the discs. Every nerve in the body leaves the spine through the spaces between the vertebrae. Increasing the space between the vertebrae reduces the pressure on the nerve roots and discs, which means less back pain.

By oscillating up and down on an inversion table a pumping action is created for fluids around the spinal discs forcing waste out and drawing in fluid around the discs. Inversion helps to relax muscles which increases blood flow through the muscles which in turn maintains the muscles in better condition and less likely to cause painful spasms.`

Posture may be improved and conditions such as scoliosis and lordosis may be helped. By reducing muscle spasm, inversion may help to realign the spine (in conjunction with other exercises).

Perhaps, the most noticeable effect of gravity on the body is compression of the spine. Our spine consists of vertebrae and sponge-like discs. The downward force of gravity causes the

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discs to lose moisture throughout the day, resulting in a daily height loss of up to 1/2" - 3/4"! The moisture returns to the disc overnight, but not 100%. Over a lifetime, a person can permanently lose between 1/2" - 2" in height

WaistHeight loss not only effects the health of your back, but acts like a "domino effect" on the rest of your body. Your organs become compressed and your waist measurement increases (without actual weight gain). You probably call these love handles, but we call them compression wrinkles because they are, in part, a direct result of compression of the spine! This also effects your ability to move and bend, which can seriously hinder your ability to perform simple daily activities.

OrgansGravity wreaks havoc on the inside of your body as well. Over time, organs begin to prolapse, or fall, from their rightful place in your body. Organ function becomes less efficient. It's not uncommon for people to experience bladder, kidney and digestive problems due to prolapsed organs. In fact, for centuries, yoga practitioners have performed head stands to ensure proper organ placement.

FlexibilityInversion devices are promoted as a tool to be used in gaining flexibility. Static-active stretching methods impossible to perform while standing can be performed upside down for the spinal flexors, side flexors and extensors, and situps are a closed-chain exercise for the hip flexors (a static-active stretch for the hip extensors) compared to the upright exercise, leg raises, which are open-chain movements. Due to increased spacing in the joint which can occur in response to traction, the

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muscles crossing that joint are pre-stretched, and as such, experience a greater lengthening compared to the equivalent joint angle while under no traction (lying down) or while being compressed (standing).

Blood flowClaims are made that inversion stimulates circulation differences due to gravity acting on the circulatory system in an opposite manner, opposing what it would normally assist, and assisting what it would normally oppose compared to standing upright. This pooling of blood and greater circulation is thought by some to increase oxygen flow to those tissues, primarily in the brain or roots of the hair,

Medical Studies on Inversion TherapyAs the popularity of inversion has grown, so, also, has the body of research to help validate the use of inversion as a clinical treatment. Some of the main areas of interest for researchers have been the reduction of back pain, decrease in lost work time and avoidance of surgery. The following is a summary of the more prominent studies in this area – references can be found at the end of this article, if the reader is interested in pursuing more detailed information.

The Nachemson study measured internal disc pressure – in the third lumbar space – through a range of activities, including standing, sitting, bending, along with vertical and supine

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traction. The study demonstrated that, when lying down, there is a residual pressure inside the discs equal to 25 per cent of standing pressure. In a separate test, this study indicated that traction equal to 60 per cent of body weight was required to reduce the standing body pressure by 25 per cent, suggesting that the pressure inside the disc could be reduced to, at, or near zero by applying traction equal to 60 per cent of body weight while in the supine position. This amount of traction is effectively applied by inverting to 60 degrees, or more, thus substantially reducing low back pain.

The Kane study demonstrated that gravity-facilitated traction produces significant intervertebral separation in the lumbar spine. The study concluded that gravity-facilitated traction may be an effective modality in the relief of low back pain.

The Nosse study found that EMG activity (an indicator of muscle pain) declined by 35 per cent within the first 10 seconds of inversion. The study also found that inversion increases spinal length, concluding that there seems to be a correlation between a reduction in EMG activity and an increase in spinal length.

The Dimberg/Volvo study evaluated 116 people in a randomized controlled trial that lasted for 12 months. Three training groups were studied, and after 12 months, the researchers showed a decrease in sick days due to back pain by 33 per cent. The average sick days lost to back pain fell by eight days per individual in the treated group. The study concluded that inversion is an efficient and inexpensive way to improve employee health and possibly reduce sick day costs to the employer.

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The Sheffield study evaluated 175 patients who were unable to work due to back pain. After eight inversion treatments, 155 patients were able to return to their jobs full time.

AVOIDING SURGERY THROUGH INVERSION THERAPYOne area of concern for today’s patients, health-care providers and payers is the avoidance of surgery. The cost of back surgery is staggering in dollars and cents as well as lost time on the job, not to mention the percentage of failed surgeries that can compound the problem for both the patient and the physician.

A preliminary study, from Newcastle Hospital, shows evidence that regular use of an inversion table may significantly reduce the need for back surgery. In this study, patients who were told that they needed surgery to relieve sciatica were divided into two groups. One group regularly practised inversion along with traditional physical therapy, while the other group received physical therapy only. The results showed that the patients in the inversion group were 70.5 per cent less likely to require surgery.

The efficacy and benefits from inversion define a broad spectrum of patients and conditions. Patients who present with numerous conditions such as herniated or bulging discs, sciatica, spondylolisthesis, scoliosis, muscle spasm and even lymphedema, can benefit from inversion. Inversion therapy can result in a reduction of pain, realignment of the vertebrae, rehydration of the intervertebral discs, relaxation of the muscles and reduction of recovery time. In addition to these

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direct benefits, the use of inversion also has been shown to stimulate venous return and the lymphatic system; stimulate the autonomic nervous system and its baroreceptors; increase oxygen flow to the brain; help maintain our original body shape and avoid prolapsed internal organs; help maintain correct posture; and contribute to overall general good health.

With such wide-ranging effects on such diverse patient populations, why wouldn’t a practitioner offer inversion in the clinic? The answer may be as diverse as the benefits of inversion itself. It is surely not due to the complexity of the treatment. Inversion is a relatively simple, cost-effective treatment that does not require highly expensive equipment or lengthy staff training. A comprehensive and effective inversion treatment program can fit into almost any type of office or clinic setting.

If more health-care providers were educated on the benefits of inversion, many patients could receive the lifelong benefits of this therapy and the cost savings to both patients and practitioner can be substantial, as we start to equalize gravity’s negative effects one patient at a time.

Health risksPeople who have heart disease, high blood pressure, eye diseases (such as glaucoma), or are pregnant are at higher risk for the dangers related to inversion therapy and should consult their doctors about it first. Such people would have to progress very slowly, starting at very light levels of inversion. The first time anyone tries inversion therapy with gravity, they should be sure to have someone standing by, in case assistance is required

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to get out of the apparatus, or if health problems are experienced.

Question

Does inversion therapy relieve back pain? Is it safe?

Answer

from Randy A. Shelerud, M.D.Inversion therapy, which involves hanging upside down, doesn't provide lasting relief from back pain, and the head-down position could be risky for anyone with high blood pressure, heart disease or glaucoma.

In theory, inversion therapy takes gravitational pressure off the nerve roots and disks in your spine and increases the space between vertebrae. One form of inversion therapy involves full-body, head-first suspension from a horizontal bar in a stabilizing frame. Another form uses a similar inversion frame with supports that keep your knees bent and hips flexed. In a third form, you lie on an inversion table that gradually tips you into a head-down position.

Inversion therapy is one example of the many ways in which spinal traction (stretching the spine) has been used in an attempt to relieve back pain. Well-designed studies evaluating traction have found the technique ineffective for long-term relief. However, some people find traction temporarily helpful as part of a more comprehensive treatment program for lower

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back pain caused by spinal disk compression.

Your heartbeat slows and your blood pressure increases when you remain inverted for more than a couple of minutes. For this reason, you should not try inversion therapy if you have cardiovascular disease or elevated pressure in your eye.

How often can / should an athlete invert?This really depends on why they are inverting. If it is to aid a back problem then initially two to three times a day is advisable. As the problem improves then frequency will be reduced. It is a good idea to include it as part of a general training regime and invert a couple of times a week at least.

What are the possible dangers of inversion therapy?Although this activity is safe we recommend seeking professional medical advice for example from your doctor before using inversion therapy equipment. The following are contraindications for inversion therapy (should not be done): pregnancy, hernia, glaucoma, retinal detachment, conjunctivitis, high blood pressure, recent stroke, heart or circulatory disorders, spinal injury, cerebal sclerosis, swollen joints, osteoporosis, unhealed fractures, surgically implanted supports, use of anticoagulants, ear infection and obesity.

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Getting Started with Inversion Therapy Before You Start - Dialogue with Your Doctor Like anything that can affect your health, talk to your doctor before you start using an inversion table. This is important because certain medications and health conditions may make using an inversion table unsafe. Your doctor may recommend against inversion table therapy if you are obese, or have a detached retina, fracture, glaucoma, heart condition (circulatory problem), hernia, implanted device, middle ear or eye infection, osteoporosis, are pregnant, or have a spinal injury. There may be other medical conditions not listed that your doctor may view as a contraindication.

What is the best way to start your inversion therapy program? Slowly - take it easy and take your time! Even at a 15-degree angle your body will feel a mild muscular stretch and the benefits of increased blood and lymph circulation. Most people do not need to exceed 60-degrees as the spine decompresses at this angle. Don't exceed what your body tells you!

Some of the better quality tables include a sliding backrest and a locking mechanism which allows you to combine gentle stretching and exercise movements during inversion. This might include moving the head from side-to-side, stretching the arms overhead, or performing abdominal sit-ups or crunches. Talk to your doctor or physical therapist about how often you can invert and specific movements to enhance your inversion therapy program.

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EXERCISES:

I ELONGATION OF THE SPINE (3 x days in the week)

a 1. a 2.

a 3. Hold in this Position a 4 . Hold in this position 0.3 min-2 min. 0.30 min – 2 min.

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b1. Hold in this position c 1. Hold in this position

0.30 min-2 min. 0.30 min-2 min.

d 1. Hold in this Position 0.30 min-2 min.

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II ABS EXERCISES (2 x days in the week)

LOWER POSITION

a. b.

c. d.

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MEDIUM POSITION

a. b.

c. d.

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HIGHER POSITION

a. b.

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II Total Body Training

Max Gym Suspension TrainingWhat is suspension training?

Suspension training is about harnessing your own body weight against gravity and performing suspended exercises to maximise strength development, stability, endurance and sculpt the body. This form of training is revolutionising workouts throughout the world as more people discover just how effective it is, and is being adopted by professional athletes and top trainers alike.

Hailed as a revolution in bodyweight training and exercise, it offers a straps form of training for people of all abilities. It allows you to leverage your own bodyweight and gravity to develop strength, balance, flexibility, and joint mobility simultaneously. Suspension training is highly adaptable to the individual, as the level of difficulty and intensity of the exercises can be determined by changing the body position or adjusting the angle at which the exercise is performed, giving you complete control over your fitness developments.

As exercises are carried out in a suspended state, rather than fixed like traditional weight training equipment, it requires a great deal of core body work to stabilize your movements against the forces of gravity. Whatever your fitness level suspension training can challenge you and you will see real developments.

What do I need for Suspension Training?

All you need to get going is a Suspension Trainer. This

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typically takes the form of two handles, with lengths of adjustable webbing which can be fixed to a stationary object such as a wall or door.

Also can be attached to any stable structure such as beams, bars, or even trees.

What are the benefits of suspension training and exercise?

Suspension training is particularly good for:

• Strength training • Flexibility training • Stability and agility training • Core body development

Suspension training offers another dimension to your staple exercises to maximise gains. For example performing exercises such as push-ups, chest flyes or inverted rows using a suspension trainer is much more difficult due to you needing to stabilize the body in the suspended state, which really promotes gains in the core body and abdominals.

Before You start.Before You Start - Dialogue with Your Doctor Like anything that can affect your health, talk to your doctor before you start using an suspension straps.

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How to Start?

EXERCISESChest

a. b.

a. b.

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Shoulder

a. b.

a. b.

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Back

a. b.

a. b.

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Triceps

a. b.

a. b.

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Biceps

a. b.

a. b.

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Lower BodyAbs

a. b.

a. b.

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a. b.

a. b.

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a. b.

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REFERENCES:

1. Klatz RM; Goldman RM; Pinchuk BG; Nelson KE; Tarr RS: The effects of gravity inversion procedures on systemic blood pressure, intraocular pressure and anteriol retinal pressure. J Am Osteopathic Assoc. 1983 Jul; 82(11) 853-857.

2. Goldman RM; Tarr RS; Pinchuk BG; Kappler RE: The Physician and Sports Medicine. March 1985.

3. Nachemson A and Elfstrom G: Intravital Dynamic Pressure Measurements in Lumbar Discs. Scandinavian Journal of Rehab Medicine, supplement, 1970.

4. Kane M, et al.: Effects of Gravity-facilitated Traction on Intervertebral Dimensions of the Lumbar Spine. Journal of Orthopedic and Sports Phys Ther. 281-288, Mar 85.

5. Nosse L.: Inverted Spinal Traction. Arch Phys Med Rehabil 59: 367-370, Aug 78.

6. Dimberg L, et al: Effects of gravity-facilitated traction of the lumbar spine in persons with chronic low back pain at the workplace.

7. Sheffield F.: Adaptation of Tilt Table for Lumbar Traction. Arch Phys Med Rehabil 45: 469-472, 1964.

8. Manjunath Prasad KS, Gregson BA, Hargreaves G, Byrnes T, Meadelow AD. Regional Neurosciences Centre, Newcastle General Hospital, Newcastle Upon Tyne, U.K.

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